Suicide attempters: biological stressmarkers and adverse life events

Risk factors for suicidal behaviour include adverse life events as well as biochemical parameters acting, e.g. within the hypothalamic–pituitary–adrenal axis and/or monoaminergic systems. The aim of the present investigation was to study stressful life events and biological stress markers among former psychiatric inpatients, who were followed up 12 years after an index suicide attempt. At the time of the index suicide attempt, and before treatment, cerebrospinal fluid (CSF) samples were taken, and 24 h (h) urine (U) was collected. 3-Methoxy-4-hydroxyphenylglycole (MHPG) in CSF and 24 h urinary samples of cortisol and noradrenaline/adrenaline (NA/A) were analysed. Data concerning stressful life events were collected retrospectively from all participants in the study through semi-structured interviews at follow-up. We found that patients who reported sexual abuse during childhood and adolescence had significantly higher levels of CSF-MHPG and U-NA/A, than those who had not. Low 24 h U-cortisol was associated with feelings of neglect during childhood and adolescence. In conclusion, this study has shown significant and discrepant biological stress-system findings in relation to some adverse life events.